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Organization

FOUR CREEKS ANESTHESIA SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LOREN K COPELAND CRNA (PROVIDER/OWNER)
(425) 614-8124
Entity
Organization

Contact information

Practice address
9730 3RD AVE NE, SUITE 200, SEATTLE, WA 98115-2023
(206) 985-9553
(206) 985-9806
Mailing address
PO BOX 97115, LAKEWOOD, WA 98497-0115
(253) 588-7911
(253) 365-6299

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30007351
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AP30007351
RN00163428 RN LICENSE
WA
Enumeration date
06/24/2009
Last updated
09/22/2016
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